All property rights in the material presented, including common-law copyright, are expressly reserved to the speaker or the ASSH. No statement or presentation made is to be regarded as dedicated to the public domain. IC25-L: Managing Burnout/Moral Injury Moderator(s): Melissa Arief, MD Faculty: Orrin I. Franko, MD, Noah M. Raizman, MD, MFA, Mark E. Baratz, MD and Simon G. Talbot, MD Session Handouts 76 th Annual Meeting of the ASSH September 30 – October 2, 2021 822 West Washington Blvd Chicago, IL 60607 Phone: (312) 880-1900 Web: www.assh.org Email: [email protected]
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All property rights in the material presented, including common-law copyright, are expressly reserved to the speaker or the ASSH.
No statement or presentation made is to be regarded as dedicated to the public domain.
IC25-L: Managing Burnout/Moral Injury
Moderator(s): Melissa Arief, MD
Faculty: Orrin I. Franko, MD, Noah M. Raizman, MD, MFA, Mark E. Baratz, MD and Simon G. Talbot, MD
• About 25-35 patients/day in office (3-3.5 days/week)
• Surgery 1-1.5 days/week
• Average 8-10 elective cases/week (low-average for hand)
• Combination of routine vs. complex cases
• Hospital call / Hand call
• Average 4 consults / week - often at convenient times
Private Practice 401K
• 11-13% invested annually surpasses Kaiser pension value
• Plus the benefits of….• You OWN the entire portfolio (your heirs inherit residual value)
• You have FREEDOM to use it• Early withdrawal if necessary
• Alternative investments
• Control over investment choices
• You have EQUITY in the practice / ASC / Ancillaries
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Retirement FundsFor more info: www.whitecoatinvestor.com
• There is no “pension” like some employed positions (Kaiser)• Kaiser pension is worth ~12-15% of your annual salary• Ex: $440k at Kaiser = $500k private practice
• Let’s do the math…Kaiser pension: 2% per year x first 20 yrs, then 1% per year.Assumption: Start at 35 yrs old, salary of $440k, work until 65 yrs old…Pension = 2% x 20 + 1% x 10 = 50% salary x $440k = $220k / yr
Payments start at 60-65 yrs, increase 8% each year deferred Payments until death or death of spouse (I think) Lump sum payment for amount above IRS limit $1.5m (est) Still have options for 401k contributions
How about if you make $500k? 4% withdrawal rate =
$219,595 / yr
AND…..
You still have $5m in the bank!
Challenges & Opportunities
• Managing Employees
• Controlling Overhead
• Strategic Decisions
• Insurance Contracts
• Income inconsistency
• Self Promotion / Marketing
• This can be mitigated with • Great office managers
• Consultants ($$)
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Office Set up
• “Low Overhead” means no extra staff• Room your own patients
• Perform your own flouro exams
• Remove / wrap your own casts
• Dictate your own notes (template + Dragon)
• Code your visits
• Patients LOVE it
*Efficiency tips discussed in other lectures
Where to FIND a JOB?
• There is no “job board” for areas in need…
• Example from my area:
2 general orthos retiring within 5 years with busy hip/knee/shoulder practices
Aging (and shrinking) call pool for general ortho and trauma at Level 2 hospital
Three surrounding ASCs that are all profitable
If you called asking for a “hand-only job” Sorry, we can’t support you
If you called for a general ortho job with call EASILY make $1M+ within 2-3 years
This is my Summary Slide
• There are GREAT jobs out there
• The BEST jobs are not “posted” anywhere
• Get in the room with the right people
• Cold call practices
• Be open to change and new opportunitiesTaking call, work comp clinics, med-legal
• Talk to friends, colleagues, acquaintances, and attendings
• When you start practice – be AWESOME and build your reputation
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Midlife InflectionMark Baratz
University of Pittsburgh Medical CenterPittsburgh, PA